Medicaid: State Efforts to Control Improper Payments Vary

State Efforts to Control Improper Payments Vary. Washington: United States General Accounting Office, 2001.

GAO surveyed state Medicaid programs and Medicaid Fraud Control Units (MFCUs) to find out about their activities to control improper payments. The study shows how low funding is for controlling improper payments and fighting fraud. The report includes a statistical summary of responses, but does not provide the detail needed to understand the relationship between variables.

Some interesting quotes from the study demonstrate how under-funded most Medicaid Fraud Control Units are:

“Half of the states spend no more than one-tenth of 1 percent of program expenditures on activities to safeguard program payments.”

“only 10 percent of MFCUs receive enough state funding to obtain even half of the allowed federal match.”

“For a MFCU that has been operating for more than 3 years, the maximum federal budget contribution is the greater of $125,000 or one-fourth of 1 percent of the total federal, state, and local expenditures of a state Medicaid program during its previous quarter.” (The state has to pay 25% of MFCU expenses.)

“less than half of the states responding to our survey reported checking whether [provider] applicants have criminal records.” p. 18